Colorectal Cancer Screening May Be Leveling Off

Tuesday, April 1, 2014
Randall H.H. Madry
Executive Director
Preventing Colorectal Cancer

A recent study by the U.S. Centers for Disease Control and Prevention (CDC) reaffirms that colorectal cancer is the second most lethal cancer in the nation, and that most colorectal cancers can be prevented. Further, despite the progress of groups such as Preventing Colorectal Cancer to educate Americans on the importance of screening, the study indicates 23 million people between the ages of 50 and 75 have never been screened for colorectal cancer.

The report, which analyzed screening rates among different populations, is a stark reminder that the efforts to educate and motivate consumers to get screened must continue. People need to reach out to those who, for one reason or another, have not undergone a screening.

Notable Trends

On a positive note, the study indicates the percentage of U.S. adults current with recommended colorectal cancer screening increased from 54% in 2002 to 65% in 2010. Colonoscopies, the gold standard of colorectal cancer screening, have been recognized as the catalyst for this increase.

Also, the gap in colorectal cancer screening rates between white and black populations no longer exists as both were screened at the same rate.

Other noteworthy trends include:

* Males, Hispanics, American Indian/Alaska Natives and those who live in non-metropolitan areas have the lowest screening rates.

* A high correlation exists between level of education, annual household incomes, and incidence of screening.

* The percentage of respondents who have never been screened was greater among those without insurance coverage (55%) and without a regular physician (61%) than those covered by health insurance (24%) and that have primary care physician (23.5%).

* Many individuals were not aware they needed to be screened nor were they notified when a screening was recommended.

Some additional findings:

* The colonoscopy is the predominant method for colorectal cancer screening in the United States.

* Many physicians believe colorectal cancer colonoscopy is the superior screening option and offer this screening option exclusively to their patients.

* Primary care physicians are the most common source for a colorectal cancer screening recommendation.

Keep on Pressing

The CDC's Colorectal Cancer Control Program established a goal of increasing the CRC screening rate to 80% by 2014. How can we move the dial from 65% to 80%? The combined efforts of primary care providers, insurance carriers, and national accreditation and government organizations will be instrumental in providing pathways of information and support to motivate individuals to undergo this potentially lifesaving procedure.

Roadblocks have been removed now that the law mandates health insurance coverage for the majority of the U.S. population, and health insurance policies are required to pay for colorectal cancer screening colonoscopies as a standard preventative measure. The opportunity to have this screening has never been more affordable with little or no out-of-pocket costs to the patient.

Aside from the cost, many people feel some level of anxiety associated with colonoscopies. The introduction of propofol now allows patients the opportunity for a pain-free procedure with no memory of the event. While not all insurance providers recognize this as a reimbursable expense, the cost savings of a screening versus treatment for Stage IV colorectal cancer is profound. Efforts to address this issue with insurance suppliers are ongoing.

Finally, statistics and analyses can motivate us, but it is up to everyone to spread the word and be the catalysts for promoting colorectal cancer screening.